digital hospital implementation | mackay base hospital · • baseline the pain points eg chart...
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Mackay HHS Digital Hospital Program
Mackay Base Hospital – Digital Hospital Implementation
Major change in a regional setting where resources are modest and occupancy is great
Mackay HHS Digital Hospital Program
Digital Hospital Programme
• Mackay was one of the original pilot sites and has been on this journey since 2013.
Princess Alexandra Hospital Digital
Exemplar
Cairns Hospital Digital Exemplar
Mackay Base Hospital
The Townsville Hospital
Royal Brisbane and Women’s Hospital
Lady Cilento Hospital
Robina Hospital
Carrara Health Centre
Gold Coast University Hospital
Gold Coast HHS (R1/R2)
Sunshine Coast University Hospital
Mackay HHS Digital Hospital Program
Who is Mackay Base Hospital
• Regional hospital
– 196 Bed facility
– 46,678 Annual ED Presentations
– 121,908 Outpatient OOS
– 1,608 Annual Births
– 5 Operating Theatres
– 6 Birth Suites
• Recently redeveloped Greenfield on Brownfield site
Mackay HHS Digital Hospital Program
2014 Releases
Mackay HHS Digital Hospital Program
Digital Release Phase 1 4/7/16
Community Health
FirstNet Replacing EDIS
Perinatal
Care Delivery Specialised
discipline view
724 Downtime Viewer
Positive Patient ID
Device Integration
ECG and CTG
Orders Entry Results Reporting
Bloods and Specimens
Mackay HHS Digital Hospital Program
One Model?
• Recommended, repeatable implementation approach was prescribed covering:
• Training approach
• Implementation model
• Go-live model
• The Mackay model
Mackay HHS Digital Hospital Program
Business Process Mapping – “As is” to “To Be”
Mackay HHS Digital Hospital Program
“As is” and “To Be” MBH Way
Mackay HHS Digital Hospital Program
Modified Go-lives
• Release one – Big Bang whole of hospital on a memorable date. Really well supported by Health Information Unit and utilised the “Dress Rehearsal” approach to teaching new processes.
• Release two – Incremental Approach starting with Alerts and Allergies, then adding direct entry and risk assessments a short time later.
• Orders Entry Results Reporting – no train no do, at the elbow in production real scenarios.
• Digital release – Rolling start eg Elective admissions in Care Compass day 1, followed by Firstnet, Emergency admissions and Perinatal day 3.
• Go-Live Approach +/- Command Centre
+/- Additional Resources
Go-Live Duration
Mackay HHS Digital Hospital Program
This is Agile
• Roving trainer – 3 staff available in recovery area of Cardiac Cath Lab, next minute – 3 WOWs with staff sitting on a bed and that’s todays training room.
• Night Shift Trainer – but they said it wouldn’t work
• Remote access to computers allows team to teach or coach real time.
Mackay HHS Digital Hospital Program
Tips in the Change and Training Space
• Dedicated change agent off line and in the project team from specific areas
• Centralised development of General Business Rules, Unit Task Analysis and training resources - in a small facility you need to do the change not just facilitate the change
• Change agent and trainer team – depends on the extent of the change, some releases the change agent became the trainer
• Agency staff to back fill staff release
• Know your workforce demographic – measure of the training model is how many times you have to re-touch staff
Mackay HHS Digital Hospital Program
What to improve:
• Baseline the pain points eg Chart turn around times, filing of pin-on times, ROI process times, radiology turn around times
• Invest time in identifying benefits and realising benefits
• Dedicated communications resource – limited access to app developers or to enormous lift door stickers.
• Governance – ask forgiveness not permission may not be the best approach
Mackay HHS Digital Hospital Program
What works
• Pick the right project team
• Size matters
• Local staff who aren’t going anywhere – can be career limiting if it doesn’t go well
• Executive support and visible leadership
• Finding the crazy leadership dancer
https://www.youtube.com/watch?v=fW8amMCVAJQ